Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases

Zhang,Ming; Sun,Ze‑Qun; Zou,Xiao‑Ping

doi:10.3892/ol.2014.2152

Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases

Authors:
- Ming Zhang
- Ze‑Qun Sun
- Xiao‑Ping Zou
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Affiliations: Gastroenterology Department, Drum Tower Hospital Affiliated Medical College of Nanjing University, Nanjing, Jiangsu 210008, P.R. China , Gastroenterology Department, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P.R. China
Published online on: May 19, 2014 https://doi.org/10.3892/ol.2014.2152
Pages: 551-555

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Abstract

Esophageal granular cell tumors (GCTs) are rare and often misdiagnosed. To demonstrate their clinicopathological features, the present study reports 19 cases and reviews the literature. There were 11 female and eight male esophageal GCT patients with a median age of 42.0 years. All the tumors were solitary. The majority of patient indications for endoscopy (89.5%) were non‑specific and endoscopic therapy was performed in 17 cases with a relapse in one case after a 12‑month follow‑up. The endoscopic appearance of esophageal GCT was variable and the majority of tumors (80.0%) were located in the middle and lower esophageal segments. The size of the tumors ranged from 0.4 to 2 cm in diameter and the surface was white‑gray, pink or yellow. Nine patients underwent an endoscopic ultrasound exam, eight of which demonstrated hypoechoic echostructures with a smooth margin and intracavity growth features. One case was derived from the muscularis propria layer with an irregular margin and intra‑ and extra‑cavity growth features. The histological features could mimic other tumors and immunohistochemical stains are usually positive for S‑100, periodic acid‑Schiff, neuron‑specific enolase and nestin. Three cases indicated pleomorphism and Ki‑67 was locally positive. Esophageal GCTs are rare and endoscopic ultrasound features are variable. Immunohistochemical staining may aid in the diagnosis.

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1	Abrikossoff A: Myomas originating from transversely striated voluntary musculature. Virchows Arch A Pathol Anat Histol. 260:215–233. 1926.(In German).
2	Morrison JG, Gray GF Jr, Dao AH and Adkins RB Jr: Granular cell tumors. Am Surg. 53:156–160. 1987.
3	De Rezende L, Lucendo AJ and Alvarez-Argüelles H: Granular cell tumors of the esophagus: report of five cases and review of diagnostic and therapeutic techniques. Dis Esophagus. 20:436–443. 2007.
4	Abrikossoff A: Further investigations on myoblastomas. Virchows Arch Pathol Anat Physiol Klin Med. 280:723–40. 1931.(In German).
5	Zhong N, Katzka DA, Smyrk TC, Wang KK and Topazian M: Endoscopic diagnosis and resection of esophageal granular cell tumors. Dis Esophagus. 24:538–543. 2011.
6	Johnston J and Helwig EB: Granular cell tumors of the gastrointestinal tract and perianal region: a study of 74 cases. Dig Dis Sci. 26:807–816. 1981.
7	Parfitt JR, McLean CA, Joseph MG, Streutker CJ, Al-Haddad S and Driman DK: Granular cell tumours of the gastrointestinal tract: expression of nestin and clinicopathological evaluation of 11 patients. Histopathology. 48:424–430. 2006.
8	Fujiwara Y, Watanabe T, Hamasaki N, Wada T, Shiba M, Uchida T, et al: Endoscopic resection of two granular cell tumours of the oesophagus. Eur J Gastroenterol Hepatol. 11:1413–1416. 1999.
9	Voskuil JH, van Dijk MM, Wagenaar SS, van Vliet AC, Timmer R and van Hees PA: Occurrence of esophageal granular cell tumors in The Netherlands between 1988 and 1994. Dig Dis Sci. 46:1610–1614. 2001.
10	Goldblum JR, Rice TW, Zuccaro G and Richter JE: Granular cell tumors of the esophagus: a clinical and pathologic study of 13 cases. Ann Thorac Surg. 62:860–865. 1996.
11	Patel RM, DeSota-LaPaix F, Sika JV, Mallaiah LR and Purow E: Granular cell tumor of the esophagus. Am J Gastroenterol. 76:519–523. 1981.
12	Palazzo L, Landi B, Cellier C, Roseau G, Chaussade S, Couturier D and Barbier J: Endosonographic features of esophageal granular cell tumors. Endoscopy. 29:850–853. 1997.
13	Garrido E, Marín E, González C, Juzgado D, Boixeda D and Vázquez-Sequeiros E: Endoscopic mucosal resection of Abrikosoff’s tumor of the esophagus. Gastroenterol Hepatol. 31:572–575. 2008.(In Spanish).
14	Schröder G and Kohlmann HW: Therapeutic endoscopy of an Abrikosov-tumor of the esophagus. Z Gastroenterol. 17:281–286. 1979.(In German).
15	Orlowska J, Pachlewski J, Gugulski A and Butruk E: A conservative approach to granular cell tumors of the esophagus: four case reports and literature review. Am J Gastroenterol. 88:311–315. 1993.
16	Radaelli F and Minoli G: Granular cell tumors of the gastrointestinal tract: Questions and answers. Gastroenterol Hepatol. 11:798–800. 2009.
17	Lack EE, Worsham GF, Callihan MD, Crawford BE, Klappenbach S, Rowden G and Chun B: Granular cell tumor: a clinicopathologic study of 110 patients. J Surg Oncol. 13:301–316. 1980.
18	Szumilo J, Dabrowski A, Skomra D and Chibowski D: Coexistence of esophageal granular cell tumor and squamous cell carcinoma: a case report. Dis Esophagus. 15:88–92. 2002.
19	Saito K, Kato H, Fukai Y, Kimura H, Miyazaki T, Kashiwabara K, et al: Esophageal granular cell tumor covered by intramucosal squamous cell carcinoma: report of a case. Surg Today. 38:651–655. 2008.
20	Prematilleke IV, Sujendran V, Warren BF, Maynard ND and Piris J: Granular cell tumour of the oesophagus mimicking a gastrointestinal stromal tumour on frozen section. Histopathology. 44:502–503. 2004.
21	Miwa K, Hattori T, Hosokawa Y, Nakamura Y, Isobe Y, Fujisawa K and Nakagawara G: Granular cell tumor of the esophagus. Gastroenterol Jpn. 21:508–512. 1986.
22	Szumiło J, Skomra D, Zinkiewicz K and Zgodziński W: Multiple synchronous granular cell tumours of the esophagus: a case report. Ann Univ Mariae Curie Sklodowska Med. 56:253–256. 2001.
23	Ohmori T, Arita N, Uraga N, Tabei R, Tani M and Okamura H: Malignant granular cell tumor of the esophagus. A case report with light and electron microscopic, histochemical, and immunohistochemical study. Acta Pathol Jpn. 37:775–783. 1987.
24	John BK, Dang NC, Hussain SA, Yang GC, Cham MD, Yantiss R, et al: Multifocal granular cell tumor presenting as an esophageal stricture. J Gastrointest Cancer. 39:107–113. 2008.
25	Maekawa H, Maekawa T, Yabuki K, Sato K, Tamazaki Y, Kudo K, et al: Multiple esophagogastric granular cell tumors. J Gastroenterol. 38:776–780. 2003.
26	Mitomi H, Matsumoto Y, Mori A, Arai N, Ishii K, Tanabe S, et al: Multifocal granular cell tumors of the gastrointestinal tract: Immunohistochemical findings compared with those of solitary tumors. Pathol Int. 54:47–51. 2004.